Breast Cancer Clinical Trial
Adding an Immunotherapy Drug, MEDI4736 (Durvalumab), to the Usual Chemotherapy Treatment (Paclitaxel, Cyclophosphamide, and Doxorubicin) for Stage II-III Breast Cancer
Summary
This phase III trial compares the addition of an immunotherapy drug (durvalumab) to usual chemotherapy versus usual chemotherapy alone in treating patients with MammaPrint Ultrahigh (MP2) stage II-III hormone receptor positive, HER2 negative breast cancer. Immunotherapy with monoclonal antibodies, such as durvalumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs, such as paclitaxel, doxorubicin, and cyclophosphamide work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. There is some evidence from previous clinical trials that people who have a MammaPrint Ultrahigh Risk result may be more likely to respond to chemotherapy and immunotherapy. Adding durvalumab to usual chemotherapy may be able to prevent the cancer from returning for patients with MP2 stage II-III hormone receptor positive, HER2 negative breast cancer.
Full Description
PRIMARY OBJECTIVE:
I. To compare breast cancer event-free survival between participants randomized to standard of care neoadjuvant chemotherapy alone versus standard of care neoadjuvant chemotherapy concurrent with durvalumab.
SECONDARY OBJECTIVES:
I. To compare pathologic complete response rates (ypT0/is, ypN0) in participants randomized to standard of care chemotherapy alone versus (vs.) standard of care neoadjuvant chemotherapy concurrent with durvalumab.
II. To compare residual cancer burden distribution between participants randomized to standard of care neoadjuvant chemotherapy vs. standard of care neoadjuvant chemotherapy concurrent with durvalumab.
III. To compare distant relapse-free survival between participants randomized to standard of care neoadjuvant chemotherapy vs. standard of care neoadjuvant chemotherapy concurrent with durvalumab.
IV. To compare overall survival between participants randomized to standard of care neoadjuvant chemotherapy vs. standard of care neoadjuvant chemotherapy concurrent with durvalumab.
V. To compare the frequency and severity of toxicities between participants randomized to standard of care neoadjuvant chemotherapy vs. standard of care neoadjuvant chemotherapy concurrent with durvalumab among those who initiate the assigned treatment.
PRIMARY QUALITY OF LIFE (QOL) OBJECTIVES:
I. To compare the change in fatigue (Patient Reported Outcomes Measurement Information System [PROMIS] Fatigue) experienced by participants randomized to neoadjuvant durvalumab plus chemotherapy vs. participants randomized to chemotherapy alone at completion of active treatment (at 20 weeks from baseline).
II. To compare the change in global physical health (PROMIS Global Health) experienced by participants randomized to neoadjuvant durvalumab plus chemotherapy vs participants randomized to chemotherapy alone at completion of active treatment (at 20 weeks from baseline).
SECONDARY QOL OBJECTIVES:
I. To compare the change in fatigue and global physical health experienced by participants randomized to neoadjuvant durvalumab plus chemotherapy vs participants randomized to chemotherapy alone during treatment (at 12 weeks from baseline).
II. To compare the changes in global physical health and fatigue subsequent to treatment (at years 1 and 2) between the two randomized study arms.
III. To compare the changes in global mental health (PROMIS Global Health) during active treatment (weeks 12, 20) and subsequent to treatment (at years 1 and 2) between the two randomized study arms.
IV. To compare the severity and frequency of treatment-related symptoms using Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) items (diarrhea, nausea, cough, shortness of breath, rash, and musculoskeletal pain) over time experienced by patients receiving neoadjuvant durvalumab plus chemotherapy versus chemotherapy alone.
BANKING OBJECTIVE:
I. To bank specimens for future correlative studies.
OUTLINE:
STEP 1: Patients without a known MammaPrint Ultrahigh (MP2) score undergo MammaPrint testing on a previously-collected tissue sample. Patients with MP2 score proceed to STEP 2.
STEP 2: Patients are randomized to 1 of 2 arms.
ARM 1: Patients receive paclitaxel intravenously (IV) over 30-60 minutes on days 1 and 8 of each cycle. Treatment repeats every 14 days for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive doxorubicin IV and cyclophosphamide IV over 30 minutes on day 1 of each cycle. Treatment repeats every 14 days for 4 cycles in the absence of disease progression or unacceptable toxicity.
ARM 2: Patients receive paclitaxel IV over 30-60 minutes on days 1 and 8 of every cycle and durvalumab IV over 60 minutes on day 1 of every other cycle. Treatment repeats every 14 days for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive doxorubicin IV and cyclophosphamide IV over 30 minutes on day 1 of each cycle, and durvalumab IV over 60 minutes on day 1 of every other cycle. Treatment repeats every 14 days for 4 cycles in the absence of disease progression or unacceptable toxicity.
All patients also undergo mammography during screening (STEP 1). Patients have the option to also undergo collection of tumor tissue during initial biopsy (STEP 1) and at standard of care (SOC) surgery, and undergo collection of blood samples prior to STEP 2 treatment, after cycle one of chemotherapy, and one month post-SOC surgery.
After completion of study treatment, patients are followed until death or 10 years, whichever occurs first.
Eligibility Criteria
Inclusion Criteria:
STEP 1: REGISTRATION (SCREENING): Participants must have histologically confirmed estrogen receptor (ER) positive and/or progesterone receptor (PR) positive (hormone receptor positive) and HER2 negative breast cancer, as per American Society of Clinical Oncology (ASCO) College of American Pathologists (CAP) guidelines
NOTE: Participants with HER2 positive disease by ASCO CAP guidelines are ineligible. HER2 negative and HER2 low or equivocal cases as per ASCO CAP guidelines that do not receive HER2 targeted therapy are eligible
STEP 1: REGISTRATION (SCREENING): Participants must have clinical stage II or III breast cancer
NOTE: Participants with inflammatory breast cancer are eligible
STEP 1: REGISTRATION (SCREENING): Participants must not have metastatic disease (i.e., must be clinically M0 or Mx) Systemic staging studies with imaging should follow routine practice as per National Comprehensive Cancer Network (NCCN) and ASCO guidelines
STEP 1: REGISTRATION (SCREENING): Participants must not have locally recurrent breast cancer
STEP 1: REGISTRATION (SCREENING): Participants with multifocal disease or synchronous primary tumors are eligible, however, all tumors must be hormone receptor positive and HER2 negative per ASCO CAP guidelines. It is sufficient to have MP2 status on at least one of the lesions
Participants must have either adequate tissue available to submit on-study or a prior known MammaPrint Index Score that is MP2 status
Submitting tissue for on-study MammaPrint testing:
Participants must have a minimum of ten, unstained formalin-fixed paraffin-embedded (FFPE) slides (4-5 micron thickness) available from initial tumor biopsy for MammaPrint assessment
NOTE: Participants must agree to have this tissue submitted to Agendia for MammaPrint Index Scoring and to have subsequent results disclosed to SWOG Cancer Research Network OR
Submitting prior known MammaPrint Index Score:
If a MammaPrint Index Score report from within the last 12 weeks is already known and is MP2 status, the participant must be registered to Step 2 immediately following Step 1 registration provided they meet all other criteria. MP2 status is defined as a MammaPrint Index score between negative 1.0 and negative 0.57 (-1.0 to -0.57, including negative 0.57) tested from initial tumor biopsy
NOTE: Participants must agree to have their commercial MammaPrint Index Score disclosed to Southwest Oncology Group (SWOG) Cancer Research Network
NOTE: Participants with prior known MammaPrint result that is not MP2 status should not be enrolled to either step of this study
STEP 1: REGISTRATION (SCREENING): Participants must not have received any prior treatment for their current breast cancer, including chemotherapy, immunotherapy, biologic or hormonal therapy, and must be candidates for doxorubicin, paclitaxel, and durvalumab therapy
STEP 1: REGISTRATION (SCREENING): Participants must be >= 18 years old at the time of registration
STEP 1: REGISTRATION (SCREENING): Participants must have a complete medical history and physical exam within 28 days prior to Step 1 Registration
STEP 1: REGISTRATION (SCREENING): Participants must have body weight > 30 kg
STEP 1: REGISTRATION (SCREENING): Participants must have Zubrod Performance Status of 0-2
STEP 1: REGISTRATION (SCREENING): Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
STEP 1: REGISTRATION (SCREENING): Participant must not have medical contraindications to receiving immunotherapy, including history of non-infectious pneumonitis that required steroids or active autoimmune disease that has required systemic treatment with disease modifying agents, corticosteroids or immunosuppressive drugs in the past two years. Replacement therapy (e.g. thyroxine for pre-existing hypothyroidism, insulin for type I diabetes mellitus, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Intra-articular steroid injections are allowed
STEP 1: REGISTRATION (SCREENING): NOTE: As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines
For participants with impaired decision-making capabilities, legally authorized representatives may sign and give informed consent on behalf of study participants in accordance with applicable federal, local, and Central Institutional Review Board (CIRB) regulations
STEP 2: RANDOMIZATION: Participants must have met all eligibility criteria for Step 1 Registration
STEP 2: RANDOMIZATION: Participants must have MP2 MammaPrint result
For participants submitting tissue for on-study MammaPrint testing:
Participants must be registered to Step 2: Randomization within 84 calendar days (12 weeks) after receiving an MP2 status from the MammaPrint Index score. MP2 status is defined as a MammaPrint Index score between negative 1.0 and negative 0.57 (-1.0 to -0.57, including negative 0.57) from initial tumor biopsy OR
Submitting commercial MammaPrint Index Score:
If a MammaPrint Index Score report from within the last 12 weeks is already known and is MP2 status, the participant must be registered to Step 2 immediately following Step 1 registration provided they meet all other criteria. MP2 status is defined as a MammaPrint Index score between negative 1.0 and negative 0.57 (-1.0 to -0.57, including negative 0.57) tested from initial tumor biopsy
STEP 2: RANDOMIZATION: Participants must not have received live vaccines within 28 days prior to study Step 2: Randomization. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, shingles, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid (oral) vaccine. Seasonal influenza vaccines and coronavirus disease 2019 (COVID-19) vaccines are allowed; however, intranasal influenza vaccines (e.g. Flu-Mist) are live attenuated vaccines, and are not allowed
STEP 2: RANDOMIZATION: Participants must not be planning to receive any concurrent non-protocol directed chemotherapy, immunotherapy, biologic or hormonal therapy for cancer treatment while receiving treatment on this study
STEP 2: RANDOMIZATION: Participant must have Zubrod Performance Status of 0-2
STEP 2: RANDOMIZATION: Participants must not have a history of (non-infectious) pneumonitis that required steroids or evidence of active pneumonitis within two years prior to Step 2: Randomization
STEP 2: RANDOMIZATION: Participants must not have active autoimmune disease that has required systemic treatment in the past two years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs) prior to Step 2: Randomization. Replacement therapy (e.g. thyroxine for pre-existing hypothyroidism, insulin for type I diabetes mellitus, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Intra-articular steroid injections are allowed
STEP 2: RANDOMIZATION: Participant must have a complete medical history and physical exam within 28 days prior to Step 2: Randomization
STEP 2: RANDOMIZATION: Leukocytes >= 3 x 10^3/uL (within 28 days prior to Step 2: Randomization)
STEP 2: RANDOMIZATION: Absolute neutrophil count >=1.5 x 10^3/uL (within 28 days prior to Step 2: Randomization)
STEP 2: RANDOMIZATION: Platelets >= 100 x 10^3/uL (within 28 days prior to Step 2: Randomization)
STEP 2: RANDOMIZATION: Total bilirubin =< institutional upper limit of normal (ULN) unless history of Gilbert's disease. Participants with history of Gilbert's disease must have total bilirubin =< 5 x institutional ULN (within 28 days prior to Step 2: Randomization)
STEP 2: RANDOMIZATION: AST/ALT =< 3 × institutional ULN (within 28 days prior to Step 2: Randomization)
STEP 2: RANDOMIZATION: Participants must have a calculated creatinine clearance >= 50 mL/min using the following Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to Step 2: Randomization
STEP 2: RANDOMIZATION: Participants must have adequate cardiac function. Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants must be class 2B or better
STEP 2: RANDOMIZATION: Participants must not have uncontrolled diabetes defined as hemoglobin A1c of 9.0% or greater, within 28 days prior to Step 2: Randomization.
STEP 2: RANDOMIZATION: Participants with history of human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy at registration and have an undetectable viral load on the most recent test results obtained within 6 months prior to Step 2: Randomization
STEP 2: RANDOMIZATION: Participants with history of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load on the most recent test results obtained while on suppressive therapy within 6 months prior to Step 2: Randomization, if indicated
STEP 2: RANDOMIZATION: Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured. Participants currently being treated for HCV infection must have undetectable HCV viral load on the most recent test results obtained within 6 months prior to Step 2: Randomization, if indicated
STEP 2: RANDOMIZATION: Participants must not be pregnant or nursing. Individuals who are of reproductive potential must have agreed to use an effective contraceptive method during protocol therapy and for 6 months following completion of protocol therapy with details provided as a part of the consent process and must have a negative pregnancy test at screening. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential." In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion, and vasectomy with testing showing no sperm in the semen. Participants should not breastfeed during protocol therapy and for 6 months following completion of protocol therapy.
STEP 2: RANDOMIZATION: Participants must be offered the opportunity to participate in specimen banking. With participant consent, specimens must be collected and submitted via the SWOG Specimen Tracking System
STEP 2: RANDOMIZATION: Participants who can complete questionnaires in English, or Spanish must be offered the opportunity to participate in the Quality of Life study
STEP 2: RANDOMIZATION: NOTE: As a part of the OPEN registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
STEP 2: RANDOMIZATION: Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines
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There are 197 Locations for this study
Jonesboro Arkansas, 72401, United States More Info
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Auburn California, 95602, United States More Info
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Bakersfield California, 93301, United States More Info
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Berkeley California, 94704, United States More Info
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Beverly Hills California, 90211, United States More Info
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Duarte California, 91010, United States More Info
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Fremont California, 94538, United States More Info
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Irvine California, 92618, United States More Info
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Los Angeles California, 90048, United States More Info
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Modesto California, 95355, United States More Info
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Newport Beach California, 92660, United States More Info
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Orange California, 92868, United States More Info
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Palm Springs California, 92262, United States More Info
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Palo Alto California, 94301, United States More Info
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Roseville California, 95661, United States More Info
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Sacramento California, 95816, United States More Info
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San Francisco California, 94115, United States More Info
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Santa Cruz California, 95065, United States More Info
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South Pasadena California, 91030, United States More Info
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Sunnyvale California, 94086, United States More Info
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Upland California, 91786, United States More Info
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Vallejo California, 94589, United States More Info
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Edwards Colorado, 81632, United States More Info
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Derby Connecticut, 06418, United States More Info
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Fairfield Connecticut, 06824, United States More Info
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Glastonbury Connecticut, 06033, United States More Info
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Greenwich Connecticut, 06830, United States More Info
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Guilford Connecticut, 06437, United States More Info
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Hartford Connecticut, 06105, United States More Info
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New Haven Connecticut, 06520, United States More Info
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North Haven Connecticut, 06473, United States More Info
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Stamford Connecticut, 06902, United States More Info
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Torrington Connecticut, 06790, United States More Info
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Trumbull Connecticut, 06611, United States More Info
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Waterbury Connecticut, 06708, United States More Info
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Waterford Connecticut, 06385, United States More Info
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Newark Delaware, 19713, United States More Info
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Newark Delaware, 19713, United States More Info
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Jupiter Florida, 33458, United States More Info
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Miami Beach Florida, 33140, United States More Info
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Savannah Georgia, 31405, United States More Info
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Boise Idaho, 83706, United States More Info
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Caldwell Idaho, 83605, United States More Info
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Coeur d'Alene Idaho, 83814, United States More Info
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Nampa Idaho, 83687, United States More Info
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Post Falls Idaho, 83854, United States More Info
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Sandpoint Idaho, 83864, United States More Info
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Bloomington Illinois, 61704, United States More Info
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Canton Illinois, 61520, United States More Info
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Carthage Illinois, 62321, United States More Info
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Chicago Illinois, 60612, United States More Info
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Danville Illinois, 61832, United States More Info
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Decatur Illinois, 62526, United States More Info
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Decatur Illinois, 62526, United States More Info
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Dixon Illinois, 61021, United States More Info
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Effingham Illinois, 62401, United States More Info
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Effingham Illinois, 62401, United States More Info
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Eureka Illinois, 61530, United States More Info
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Galesburg Illinois, 61401, United States More Info
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Kewanee Illinois, 61443, United States More Info
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Macomb Illinois, 61455, United States More Info
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Mattoon Illinois, 61938, United States More Info
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Maywood Illinois, 60153, United States More Info
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Moline Illinois, 61265, United States More Info
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O'Fallon Illinois, 62269, United States More Info
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Ottawa Illinois, 61350, United States More Info
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Pekin Illinois, 61554, United States More Info
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Peoria Illinois, 61615, United States More Info
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Peru Illinois, 61354, United States More Info
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Princeton Illinois, 61356, United States More Info
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Shiloh Illinois, 62269, United States More Info
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Springfield Illinois, 62702, United States More Info
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Springfield Illinois, 62702, United States More Info
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Springfield Illinois, 62781, United States More Info
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Urbana Illinois, 61801, United States More Info
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Washington Illinois, 61571, United States More Info
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Crown Point Indiana, 46307, United States More Info
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Dyer Indiana, 46311, United States More Info
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Hobart Indiana, 46342, United States More Info
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Hobart Indiana, 46342, United States More Info
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Indianapolis Indiana, 46312, United States More Info
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Munster Indiana, 46321, United States More Info
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Munster Indiana, 46321, United States More Info
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Valparaiso Indiana, 46383, United States More Info
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Ankeny Iowa, 50023, United States More Info
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Clive Iowa, 50325, United States More Info
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Des Moines Iowa, 50314, United States More Info
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Des Moines Iowa, 50314, United States More Info
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Kansas City Kansas, 66160, United States More Info
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Overland Park Kansas, 66210, United States More Info
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Overland Park Kansas, 66211, United States More Info
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Topeka Kansas, 66606, United States More Info
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Westwood Kansas, 66205, United States More Info
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Monroe Louisiana, 71202, United States More Info
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Shreveport Louisiana, 71103, United States More Info
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Shreveport Louisiana, 71106, United States More Info
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Baltimore Maryland, 21215, United States More Info
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Bel Air Maryland, 21014, United States More Info
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Westminster Maryland, 21157, United States More Info
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Ann Arbor Michigan, 48106, United States More Info
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Ann Arbor Michigan, 48109, United States More Info
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Brighton Michigan, 48114, United States More Info
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Brighton Michigan, 48114, United States More Info
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Canton Michigan, 48188, United States More Info
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Canton Michigan, 48188, United States More Info
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Chelsea Michigan, 48118, United States More Info
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Chelsea Michigan, 48118, United States More Info
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Detroit Michigan, 48201, United States More Info
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Detroit Michigan, 48202, United States More Info
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Farmington Hills Michigan, 48334, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Lansing Michigan, 48912, United States More Info
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Livonia Michigan, 48154, United States More Info
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Novi Michigan, 48374, United States More Info
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Pontiac Michigan, 48341, United States More Info
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Saginaw Michigan, 48601, United States More Info
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Saginaw Michigan, 48604, United States More Info
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Southfield Michigan, 48075, United States More Info
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Tawas City Michigan, 48764, United States More Info
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West Branch Michigan, 48661, United States More Info
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Ypsilanti Michigan, 48106, United States More Info
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Ypsilanti Michigan, 48197, United States More Info
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Minneapolis Minnesota, 55415, United States More Info
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Columbus Mississippi, 39705, United States More Info
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Grenada Mississippi, 38901, United States More Info
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New Albany Mississippi, 38652, United States More Info
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Oxford Mississippi, 38655, United States More Info
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Southhaven Mississippi, 38671, United States More Info
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Cape Girardeau Missouri, 63703, United States More Info
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Creve Coeur Missouri, 63141, United States More Info
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Farmington Missouri, 63640, United States More Info
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Kansas City Missouri, 64154, United States More Info
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Lee's Summit Missouri, 64064, United States More Info
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North Kansas City Missouri, 64116, United States More Info
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Saint Louis Missouri, 63110, United States More Info
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Saint Louis Missouri, 63129, United States More Info
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Saint Louis Missouri, 63131, United States More Info
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Saint Louis Missouri, 63136, United States More Info
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Saint Peters Missouri, 63376, United States More Info
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Sainte Genevieve Missouri, 63670, United States More Info
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Sullivan Missouri, 63080, United States More Info
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Sunset Hills Missouri, 63127, United States More Info
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Anaconda Montana, 59711, United States More Info
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Billings Montana, 59101, United States More Info
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Bozeman Montana, 59715, United States More Info
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Great Falls Montana, 59405, United States More Info
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Missoula Montana, 59804, United States More Info
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Henderson Nevada, 89052, United States More Info
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Las Vegas Nevada, 89102, United States More Info
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Las Vegas Nevada, 89148, United States More Info
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Elizabeth New Jersey, 07207, United States More Info
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Hamilton New Jersey, 08690, United States More Info
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Jersey City New Jersey, 07302, United States More Info
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Lakewood New Jersey, 08701, United States More Info
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Long Branch New Jersey, 07740, United States More Info
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New Brunswick New Jersey, 08903, United States More Info
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Newark New Jersey, 07112, United States More Info
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Somerville New Jersey, 08876, United States More Info
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Toms River New Jersey, 08755, United States More Info
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Brooklyn New York, 11220, United States More Info
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Glens Falls New York, 12801, United States More Info
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Mineola New York, 11501, United States More Info
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New York New York, 10016, United States More Info
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Cary North Carolina, 27518, United States More Info
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Clinton North Carolina, 28328, United States More Info
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Garner North Carolina, 27529, United States More Info
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Goldsboro North Carolina, 27534, United States More Info
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Jacksonville North Carolina, 28546, United States More Info
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Raleigh North Carolina, 27607, United States More Info
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Raleigh North Carolina, 27614, United States More Info
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Centerville Ohio, 45459, United States More Info
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Cleveland Ohio, 44109, United States More Info
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Dayton Ohio, 45409, United States More Info
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Dayton Ohio, 45409, United States More Info
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Dayton Ohio, 45415, United States More Info
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Franklin Ohio, 45005, United States More Info
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Greenville Ohio, 45331, United States More Info
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Sylvania Ohio, 43560, United States More Info
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Troy Ohio, 45373, United States More Info
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Oklahoma City Oklahoma, 73104, United States More Info
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Tulsa Oklahoma, 74146, United States More Info
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Gresham Oregon, 97030, United States More Info
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Newberg Oregon, 97132, United States More Info
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Ontario Oregon, 97914, United States More Info
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Oregon City Oregon, 97045, United States More Info
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Portland Oregon, 97210, United States More Info
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Portland Oregon, 97213, United States More Info
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Portland Oregon, 97225, United States More Info
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Tualatin Oregon, 97062, United States More Info
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Westerly Rhode Island, 02891, United States More Info
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Bluffton South Carolina, 29910, United States More Info
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Georgetown South Carolina, 29440, United States More Info
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Hilton Head Island South Carolina, 29926, United States More Info
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Collierville Tennessee, 38017, United States More Info
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Memphis Tennessee, 38120, United States More Info
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Houston Texas, 77030, United States More Info
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San Antonio Texas, 78229, United States More Info
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Richmond Virginia, 23235, United States More Info
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Richmond Virginia, 23298, United States More Info
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Tacoma Washington, 98405, United States More Info
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Vancouver Washington, 98684, United States More Info
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Vancouver Washington, 98686, United States More Info
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Charleston West Virginia, 25304, United States More Info
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Green Bay Wisconsin, 54301, United States More Info
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Green Bay Wisconsin, 54303, United States More Info
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Oconto Falls Wisconsin, 54154, United States More Info
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Sheboygan Wisconsin, 53081, United States More Info
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Sturgeon Bay Wisconsin, 54235, United States More Info
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